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RAVEN ENNIS
NPI 1407278757
Nurse Practitioner - Psychiatric/Mental Health in Las Vegas, NV

Active since January 06, 2014
4270 S DECATUR BLVD STE B6, LAS VEGAS, NV 89103(702) 485-2100(702) 825-0091 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 22, 2021, May 23, 2019 (2 updates tracked since 2019).

About Raven Ennis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAVEN ENNIS (NPI 1407278757) is an individual psychiatric/mental health provider in Las Vegas, Nevada, licensed in Nevada (APRN002372) and active in the NPI registry since January 2014. She maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1407278757
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameRAVEN ENNIS
Location Address4270 S DECATUR BLVD STE B6Las Vegas, NV 89103-6802
Mailing Address4270 S Decatur Blvd Ste B6Las Vegas, NV 89103-6802 · (702) 485-2100 · Fax (702) 825-0091
Phone(702) 485-2100
Fax(702) 825-0091
Sole ProprietorNo
Enumeration DateJanuary 6, 2014
Last NPPES UpdateMarch 22, 20212 updates tracked since enumeration
NPPES CertifiedMarch 22, 2021
✔ NPI 1407278757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NV · APRN002372
Also ListedRegistered NurseTaxonomy 163W00000X · License RN73437 (NV)
4270 S DECATUR BLVD STE B6, Las Vegas, NV 89103
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Secondary Practice Location 1

Location 1330 S Valley View BlvdLas Vegas, NV 89107-4361 · Phone (702) 759-0882

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE CELESTE LASSEIGNE PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100
JAYMIE ALVAREZ
Physician Assistant
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100
LACEY STORR
Nurse Practitioner (Family)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100
YING-CHIA CHENG DO
Psychiatry & Neurology (Psychiatry)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100
MR. MICHAEL TODD MATHISEN APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100
DR. JUSTIN PETRIE D.O.
Psychiatry & Neurology (Psychiatry)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100
MRS. AMANDA JO WARE MSW
Social Worker (Clinical)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 447-0514
ZELLUYAH W GAITHO APN
Nurse Practitioner (Psychiatric/Mental Health)
4270 S DECATUR BLVD STE B6
LAS VEGAS, NV 89103
Clark County (702) 485-2100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raven Ennis's NPI number?

The NPI number for Raven Ennis is 1407278757. It was assigned to this individual provider in the NPPES registry on January 6, 2014.

Where is Raven Ennis located?

Raven Ennis practices at 4270 S Decatur Blvd Ste B6, Las Vegas, NV 89103. The listed phone number is (702) 485-2100.

What is Raven Ennis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

What insurance does Raven Ennis accept?

Health plans from Blue Cross and Blue Shield of Texas and Providence Health Plan list Raven Ennis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raven Ennis was last updated on March 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.